The question on the difference between the three professions of chiropractors, osteopaths and physiotherapy is a commonly asked question, so here we explain the differences.
The primary focus of chiropractic care centers around the spine. It is
felt that most painful problems ultimately lead back to the spine.
Chiropractors usually adjust the spine to correct positional faults.
While they do treat other areas of the body, such as correcting foot
alignment, their main focus is the spine, but also have a very strong
backround in nutritional assessment. They primarily use a hands on
approach, but also occasionally use treatment modalities such as
electrical stimulation, ultrasound, etc. Chiropractic physicians earn a
"D.C." or a doctor of chiropratic.
Osteopathic physicains also have a basis in manipulative therapy and can
also perform adjustments. Yet, they also have a backround in medicine
and can prescibe medications and work in hospitals. They treat a variety
of medical and orthopedic conditions. An osteopathic physican is
denoted by "D.O." or doctor of osteopathy.
Physiotherapists or physical therapist is one of the allied health professions whose primary focus is on the recovery of function. It may be to help restore movement or reduce pain. This may be done by a variety of techniques such as strengthening, stretching, modalities, joint mobilization, massage, neuromuscular facilitation, etc. PT's treat people with a variety of condtions such as neurological problems (like MS, Parkinson's disease), orthopedic problems (back pain, after shoulder surgery, etc.), wound care, lymphedema management, etc. A physical therapist cannot prescribe medication, yet this is not their focus. In some states, one cannot see a physical therapist without first having an order from a physician, but most states have some degree of direct access.
Common Misconception: that chiropractors "do" spine, and physiotherapists do all else.
This is not true, physiotherapists treats all spine (back and neck problems), especially more true in physios who specialize in back and neck physiotherapy (my wife Louise is an example where she dedicates her time to reading and advancing her knowledge and skills in managing back and neck conditions).
Running a physiotherapy, hand therapy and sports massage practice here in Singapore, we often hear our patients being told misguided information such as:
Qualified physiotherapists, hand therapists and sports massage therapists are trained and skilled in the assessment and rehabilitation of all orthopedic and musculoskeletal conditions, this means that conditions of the bones, tendons, muscles, ligaments, joints and nerves are common conditions that we manage every day.
To top it off, back and neck conditions such as low back pain, neck aches and pains, upper back tightness, slipped discs etc - these are too common conditions that most physiotherapists do. Of course, you can request for physiotherapists who specialize in your area/condition - many physiotherapists have specializations or special interest such as sports, spinal, hands, sports massage etc.
What's the difference of the treatment by chiropractors versus physio?
The fundamental hands-on approach of chiropractic treatment is spinal manipulation, on top of advice on nutrition and basic exercises. This is because of their philosophy / belief of care, that all issues stem from the joints in the back and neck, so manipulation is the utmost and only way to manage pain.
Spinal manipulation is but one of the modalities that physiotherapists can do...but we tend to choose a gentler and safer solution to start such as heating first to loosen tightened structures, exercise followed by joint mobilization to allow structures to glide. Sometimes we may combine it with deep tissue massage, nerve/muscle/joint glide activity as well.
"While spinal manipulation may relieve neck or back pain in many cases, the pain-relieving effects may not always be long-lasting. There is also the possibility of spinal manipulations causing a stroke, although this risk is considered rare. Harsh twisting, rather than gentle manipulations of the spine's discs, has the most risk for damage."
Many people understand that spinal joint manipulation is "putting joints back into where they've slipped out" but really, there's no evidence to support this understanding. On the other hand, there's evidence that regardless of manipulation (external force to "snap" joints) versus mobilization (gentler, guiding version) - benefits are achieved mainly by loosening up a joint which has become stiff, causing restriction and pain.
Evidence based practice advocates active treatment which results in best functional and clinical outcomes for patients. When exercises is added on top of mobilization and/or manipulation, benefits are multiplied as compared to mobilization/manipulation alone. Plus, understanding the reasons and contributing factors to the conditions often helps patients to modify their lifestyles, accelerating healing.
Physiotherapists return the power and independence to you, giving you the opportunity and chance to return to full independence on your own without having the need to come back to us again and again and again for "top up". How we do this is by dealing with the root cause of the pain, not just treat the pain symptomatically and go.
We also provide you with home exercise programs and solutions that you can do on your own at home or at work which will provide both immediate relief and prevent recurrence in the long run.
Most physiotherapy sessions are between 6 - 12 sessions, done over 4 - 12 weeks. Sometimes, patients are discharged within 4 sessions as they are healed completely. Why so little sessions are required depends on several factors: